Dr Dennis T H Lim
Head and Neck General SurgeonMBBS, M.Med (Surg), FRCS (Edin), FRCS (Glas), FAMS
The parathyroid glands are four tiny glands located behind the thyroid gland in the neck. Despite their small size, they play a vital role in maintaining the body’s balance by regulating calcium and phosphorus levels in the blood, which are vital for bone strength, nerve function and muscle contraction.
When these glands produce too much or too little parathyroid hormone (PTH), it can disrupt this balance, leading to issues that affect both bone density and kidney health. In some cases, conditions such as tumours or cancer may develop. Regularly checking PTH levels and consulting an oncologist in Singapore for proper evaluation can help with early detection and timely treatment.
Parathyroid hormone (PTH) is released by the parathyroid glands to keep calcium within a healthy range. Balanced levels support bone density and reduce kidney strain by preventing calcium buildup.
PTH helps regulate calcium by:
When parathyroid hormone (PTH) levels are normal, the bones stay strong, and the kidneys effectively regulate the body’s mineral balance. However, abnormal PTH levels can lead to significant health issues.
When PTH levels are too high, excess calcium is drawn from the bones, causing them to weaken over time. The kidneys then work harder to remove the excess calcium, which can sometimes result in kidney stones. Conversely, when PTH levels are too low, blood calcium levels drop, disrupting normal muscle and nerve function, which may lead to symptoms such as muscle cramps, tingling or spasms.
When PTH levels stay within the normal range, bones maintain their density and strength. However, a prolonged imbalance can lead to bone loss, weakening the skeleton and increasing the risk of fractures and long-term complications.
Parathyroid disorders can cause osteoporosis, most commonly affecting the hips, spine and wrists. Fragile bones in these areas make daily activities more dangerous, while fractures can lead to longer recovery times and reduced quality of life.
Research shows that parathyroid surgery can significantly improve bone density, especially in the spine and femoral neck. These gains are often visible within 6 to 12 months, lowering fracture risk and restoring skeletal strength.
After surgery, bones may rapidly absorb calcium as they begin to rebuild strength. This condition, known as hungry bone syndrome, requires careful monitoring and supplementation to restore calcium balance and support recovery.
When calcium levels in the blood are too high, the kidneys must filter and excrete the excess. Over time, this can lead to calcium crystals forming kidney stones, which cause severe pain and increase the risk of urinary tract infections.
Prolonged high calcium levels can cause calcium deposits to build up within kidney tissues, a condition known as renal calcification. This can damage the kidneys and accelerate the decline in patients with chronic kidney disease.
For some patients, parathyroid surgery (parathyroidectomy) can help stabilise or even improve kidney function. By lowering calcium overload and PTH levels, it reduces the risk of kidney stones and slows disease progression.
Yes, kidney diseases can affect the parathyroid glands, most notably through a condition called secondary hyperparathyroidism. This often occurs in people with chronic kidney disease. When the kidneys are not functioning well, they are less able to convert vitamin D into its active form or remove excess phosphorus from the body. As a result, blood calcium levels drop, prompting the parathyroid glands to release more PTH to restore balance.
Over time, this continuous overactivity causes the parathyroid glands to enlarge and maintain persistently high PTH levels. This can further harm both the bones and kidneys, creating a cycle of worsening health issues if left untreated.
Parathyroid disorders can silently affect both bones and kidneys, leading to long-term complications if untreated. When they malfunction, the effects may go unnoticed until significant problems arise. Surgery often helps restore calcium balance, but recovery still requires careful aftercare.
If you would like to check your PTH levels or better understand your treatment options, book a consultation with us for a personalised assessment today.
Head and Neck General SurgeonMBBS, M.Med (Surg), FRCS (Edin), FRCS (Glas), FAMS
Dr Dennis T H Lim is a specialist in head and neck surgical oncology, with expertise in cancers of the thyroid, parotid gland, head and neck, and melanoma. Trained at the Memorial Sloan-Kettering Cancer Center, New York, Dr Lim previously served as Senior Consultant Surgical Oncologist at the National Cancer Centre and Singapore General Hospital. He now runs a private practice, providing personalised, multidisciplinary care using advanced surgical techniques to optimise outcomes for patients with head and neck cancers.
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